Saez Alejandro, Moreno Raul
Division of Interventional Cardiology, University Hospital La Paz, Madrid, Spain.
Med Devices (Auckl). 2010;3:51-6. doi: 10.2147/MDER.S4422. Epub 2010 Sep 13.
Bare metal stents enabled a reduction in the risk of early procedural complications and restenosis in comparison with balloon angioplasty alone, but introduced a new and device-specific iatrogenic condition, ie, in-stent restenosis due to increased neointimal hyperplasia. Sirolimus- and paclitaxel-eluting stents reduce restenosis and the need for new revascularizations in comparison with bare metal stents, although at the cost of a slight increase in the risk of late stent thrombosis and a need for prolonged dual antiplatelet therapy. Everolimus is an analog of sirolimus with an increased solubility. In this review, the currently available evidence for everolimus-eluting stents is revised, including randomized trials against bare metal stents, and head-to-head trials comparing this stent with other drug-eluting stents.
与单纯球囊血管成形术相比,裸金属支架可降低早期手术并发症和再狭窄的风险,但引入了一种新的、与器械相关的医源性疾病,即由于新生内膜增生增加导致的支架内再狭窄。与裸金属支架相比,西罗莫司和紫杉醇洗脱支架可减少再狭窄和再次血管重建的需求,尽管代价是晚期支架血栓形成风险略有增加以及需要延长双联抗血小板治疗。依维莫司是西罗莫司的类似物,溶解度增加。在本综述中,对依维莫司洗脱支架的现有证据进行了修订,包括与裸金属支架对比的随机试验,以及将该支架与其他药物洗脱支架进行对比的头对头试验。